Immunization Final- Self Study Exam ?s – Flashcards
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To reduce liability, pharmacists administering immunizations should take the following three steps:
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Receive specialized training and stay current with vaccine information updates; educate patients about the benefits and risks of vaccinations; and emulate local standards of care.
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Can technicians administer vaccinations?
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No
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RotaTeq should be administered as a:
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3-dose series to infants at 2, 4, and 6 months of age.
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Robert is a 48-year-old pharmacist who is preparing to provide immunizations in his pharmacy for the first time next fall. He has no documentation of receiving the hepatitis B vaccine and would like to be vaccinated before administering vaccines in his practice. What is the recommended routine schedule for vaccination against hepatitis B?
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0, 1, and 6 months.
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Which of the following statements about establishing clinics for administering vaccines is true?
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Technicians can administer screening questionnaires and distribute VIS
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Which of the following vaccines should be administered to all pregnant women?
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IIV. (and Tdap @ 27-36 weeks)
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Pregnant women should not get what kind of vaccines?
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Live
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If a patient is a candidate for revaccination with PPSV23, what is the ACIP-recommended interval between doses of this vaccine?
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5 years.
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Which of the following is most likely to result in an influenza pandemic?
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Antigenic shift in an influenza A virus.
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Antigenic shifts produce ________ changes in type _____ antigens
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MAJOR; A
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Antigenic drifts produce ________ changes in type ______ antigens
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minor; A and B
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Children are more likely to get what type of influenza strain?
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B
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Which type of influenza strain is responsible for pandemics?
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A
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How long does immunity from the influenza vaccine typically last?
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6-8 months
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If a baby is born prematurely, do you need to adjust their vaccination schedule to begin at their due date?
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No, no adjustment--use actual birthday
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True or false: you should never vaccinate somebody with a mild illness? (mild fever, upper respiratory tract infection, otitis media, mild diarrhea)
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False--you can vaccinate people with mild illnesses
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Will administering multiple vaccines on one day produce adverse effects?
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No
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Can a pregnant pharmacist administer a live vaccine?
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Yes
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Which type of vaccine involves stimulation of B cells without the assistance of T helper cells?
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Pure polysaccharide vaccines
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Which of the following best describes an opportunity for pharmacists to use diagnosis-based screening to identify people at risk for vaccine-preventable diseases?
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Performing a medication review for a patient who has diabetes.
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Which of the following is recognized by sociologists as a factor in a patient's decision whether to be vaccinated?
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Influence of a health care provider.
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Administration of immunoglobulin following exposure to a pathogen is an example of which type of immunity?
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Passive immunity.
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How long must pharmacists maintain records of immunizations?
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For the patient's lifetime.
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Which of the following statements would be accurate when responding to a patient's concerns about vaccines?
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The immune system is capable of stimulating an immune response to multiple vaccines administered at the same time.
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Tom is a 9-month-old boy who received his last set of vaccinations 3 months ago. Tom's mother shows you his up-to-date immunization record and reports that he has never had any adverse reactions to vaccinations. You notice that he has not received an influenza vaccine in the past. What dose of IIV should be administered to Tom?
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0.25 mL.
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Name the vaccine-preventable disease that may be contracted by unimmunized children from adults (who can serve as a reservoir for the disease), which causes a paroxysmal cough and potentially can result in pneumonia, seizures, encephalopathy, hypoxia, and death.
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Pertussis.
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Which of the following statements is true regarding how vaccines evoke an immune response?
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The antigen in the vaccine activates B cells, which produce antigen-specific antibodies and memory cells.
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Which of the following statements is true regarding varicella-containing vaccines?
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The potency of HZV is greater than that of varicella vaccine.
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HealthMap Vaccine Finder is a free online tool that allows pharmacists to:
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List their vaccination services so patients can find them when searching the website for nearby immunizers.
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If a patient received the first dose of HepB but did not return for the remaining doses in the series, under what circumstances should the HepB series be restarted?
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The series should not be restarted; resume the series where it was interrupted.
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Kyle is a 5-year-old boy who is up to date with his vaccinations. He has never experienced any adverse effects from vaccinations. At his next well-child check-up, Kyle will be receiving the following vaccines: IPV, MMR, varicella vaccine, and a tetanus-containing vaccine. Which of the following tetanus-containing vaccines would be appropriate for him?
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DTaP.
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Which of the following key questions is important to ask a patient before administering IIV?
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Are you sick today?
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Which type of immune response targets pathogens that have entered the cells of the host?
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Cell-mediated immunity.
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Which disease was the leading cause of acquired mental retardation before introduction of a vaccine?
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Rubella.
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Kate is a 24-year-old woman with asthma. She requests a refill of her albuterol inhaler on November 1st. Kate's immunization record indicates that she completed the primary series of MMR, varicella, DTaP, HepA, and HepB vaccines, and she received a dose of Tdap 2 years ago. For complete coverage, which of the following vaccines should she receive?
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PPSV23, IIV, and HPV.
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Which of the following vaccines is recommended for infants to receive at birth?
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Hepatitis B.
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For a patient who is going to receive IIV and HZV, which of the following best describes appropriate administration of these vaccines?
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Administer these 2 vaccines at the same visit, using injection sites on opposite arms or at least 1 inch apart if using the same arm.
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According to ACIP recommendations, what is the maximum number of doses of PPSV23 a patient should receive in his or her lifetime?
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3 doses.
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HZV should not be administered to a patient with a history of anaphylaxis to:
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Gelatin.
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The incubation period for influenza can range from:
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1 to 4 days.
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Which of the following diseases has been successfully eradicated worldwide through vaccination efforts?
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Smallpox.
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The childhood/adolescent and adult immunization schedules are updated and published annually during which months?
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January or February.
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Which of the following tetanus booster vaccines would be most appropriate for administration to a 12-year-old boy who has completed a primary series with DTaP and has no known allergies?
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Tdap.
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Alex is a 32-year-old man who is scheduled to travel to a country where hepatitis A is endemic. He received his first dose of hepatitis A vaccine today. Alex should be counseled to return for his second dose of hepatitis A vaccine:
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In 6 months.
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After reconstitution, within what time frame must HZV be administered?
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30 minutes.
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Which publication does the CDC generally use to quickly notify providers of updates to vaccine recommendations?
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MMWR.
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Justin is a healthy 16-year-old boy who has no documentation of varicella vaccine or history of the disease. He should receive:
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2 doses of varicella vaccine separated by at least 4 weeks.
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Aiden is a 6-month-old healthy boy with no known allergies. He has received vaccinations in the past with no reported adverse reactions. Aiden's father asks about having his son vaccinated against influenza. The most appropriate response would be to inform the father that Aiden:
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Should receive 1 dose of Fluzone today followed by a second dose of Fluzone administered 4 weeks later.
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What is the only flu vaccine approved for patients under 3 years old?
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Fluzone IIV
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Which of the following is a requirement of Occupational Safety and Health Administration's (OSHA's) Bloodborne Pathogens Standard?
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Health care providers must use safety devices when administering injectable vaccines.
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Which disease is almost certain to cause death if infected patients do not receive postexposure prophylaxis?
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Rabies.
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According to ACIP recommendations, HZV is indicated for the prevention of herpes zoster in adults aged:
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60 years and older.
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According to the Advisory Committee on Immunization Practices (ACIP), which of the following would be considered adequate evidence of immunity to varicella, indicating that administration of varicella vaccine is unnecessary?
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Diagnosis of chickenpox by a health care provider.
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Ava has arrived at the clinic for her well-child visit. She is 4 months old. Ava's immunization record reveals that she has received the following vaccines:
2 doses of HepB
1 dose of Hib
1 dose of rotavirus
1 dose of PCV13
1 dose of DTaP
1 dose of IPV
Which vaccines should Ava receive at today's visit?
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DTaP, Hib, PCV13, IPV, and rotavirus.
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What is the minimum needle length is recommended for administering HepB vaccine to an adult patient weighing 130 lb?
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1 inch.
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Which disease is characterized by the development of a membrane on the tonsils, pharynx, or larynx, leading to respiratory obstruction?
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Diphtheria.
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After completion of a primary vaccine series and documentation of a one-time dose of Tdap, Td booster doses are recommended every:
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10 years.
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Which of the following statements is true regarding the difference in coverage between Gardasil and Cervarix?
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Gardasil will provide protection against diseases caused by HPV types 6, 11, 16, and 18, whereas Cervarix will provide protection against diseases caused by HPV types 16 and 18.
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Which of the following patients should receive the MMR vaccine?
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A pharmacist born in 1975 with documentation of 1 dose of MMR vaccine.
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Which of the following vaccine-preventable diseases had the highest incidence in the United States in 2012?
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Pertussis.
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Which of the following vaccines containing tetanus, diphtheria, and/or pertussis would be most appropriate for administration to a 69-year-old man who is preparing to travel to see his newborn granddaughter next month?
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Tdap.
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Which of the following patients would be a candidate for PPSV23?
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33-year-old woman who is pregnant.
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Which of the following immunization strategies is preferred for adults under the age of 65 years with immunocompromising conditions who require both PCV13 and PPSV23?
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PCV13 first, followed by PPSV23 at least 8 weeks later
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The presence of fever, diffuse maculopapular rash, and Koplik spots are characteristic of which of the following diseases?
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Measles.
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Live vaccines are contraindicated in a patient who:
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Is immunosuppressed.
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A history of anaphylaxis caused by neomycin would be a contraindication to receiving which of the following vaccines?
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IPV.
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What is the standard dose of epinephrine for managing anaphylaxis?
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0.01 mg per kg body weight, up to a maximum of 0.5 mg
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Which of the following statements is true regarding administration of LAIV?
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Administer with the patient's head tilted slightly backward.
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Barbara is a 60-year-old woman who presents to the pharmacy for two vaccines: HZV and IIV. Which of the following are the appropriate doses and routes for administering these vaccines to this patient?
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HZV 0.65 mL subcutaneously; IIV 0.5 mL intramuscularly.
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David is a healthy 5-year-old boy who is scheduled to see his pediatrician for a checkup in July prior to starting kindergarten. David's immunization record reveals that he has received the following vaccines:
3 doses of HepB
4 doses of PCV
2 doses of HepA
3 doses of IPV
3 doses of rotavirus
1 dose of MMR
4 doses of DTaP
1 dose of varicella
4 doses of Hib
Which vaccines should David receive at this visit?
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DTaP, IPV, MMR, and varicella.
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Emily is a 16-year-old high-school student with no chronic medical conditions. Emily's immunization record shows that she completed the primary series for IPV, HepA, Hib, DTaP, and MMR, and she had a physician-diagnosed case of chickenpox at 2 years of age. Which of the following would be the most appropriate recommendation for her today?
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Tdap, HPV, MCV, HepB, and influenza, if during influenza season.
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How often should an adult patient with a history of heart failure receive IIV to prevent influenza?
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Annually.
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Which of the following documents must be given to every patient or patient's caregiver before administration of a vaccine covered by the NCVIA?
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VIS.
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Which influenza vaccine is approved by the FDA for use in patients with severe egg allergy?
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RIV.
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HPV vaccine is recommended for which of the following individuals?
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12-year-old boy.
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Mark, a 65-year-old man, is a candidate for the following vaccines: IIV3 or IIV4, PPSV23, zoster, and a booster dose of Td. Which of these vaccines is a live attenuated vaccine?
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Zoster.
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Herd immunity refers to which of the following situations?
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Vaccination of enough individuals in a community to prevent disease from circulating
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Alan is a 47-year-old man who has no documentation of a primary series of tetanus-containing vaccine. Which of the following would be an appropriate primary series for Alan?
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Tdap today; Td in 4 weeks; Td 6 months after the second dose.
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A history of anaphylaxis caused by gelatin would be a contraindication to receiving which of the following vaccines?
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Varicella.
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What is meant by the term "immunization neighborhood"?
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Immunization stakeholders collaborate to meet community immunization needs.
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There should be a flat hard surface in the area where vaccines will be administered to ensure:
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There is room for the patient to lie down if fainting occurs or CPR is required.
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All Medicare Part B enrollees are covered for which two vaccines?
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Influenza and pneumococcal.
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Which viruses are associated with the development of cancer?
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Human papillomavirus and hepatitis B virus
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The documentation system that health care providers should use to report serious adverse events after vaccination is:
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VAERS.
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According to ACIP recommendations, which of the following needle lengths would be appropriate for administering HZV to an adult patient?
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⅝ inch.
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Which of the following best describes how to administer MMR vaccine to an adult patient weighing 155 lb?
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Inject subcutaneously at a 45° angle in the outer aspect of the upper arm.
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According to ACIP, which of the following is a contraindication to receiving HZV?
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Current treatment for lymphoma.
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In the event that a young child is fussy following the receipt of a vaccine, pharmacists should advise parents to:
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Comfort the child and engage in quiet activities.
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A health care provider who previously has not been vaccinated against hepatitis B is stuck by a contaminated needle after administering an immunization to a hepatitis B positive patient during a seasonal influenza clinic. In addition to hepatitis B vaccine, the health care provider also should receive hepatitis B Immunoglobulin (HBIG) as postexposure prophylaxis because the HBIG provides:
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Long-term protection while the vaccine provides prompt immunity.
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Which of the following diseases are transmitted through mosquito bites?
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Yellow fever and Japanese encephalitis.
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Which of the following statements about pharmacy-based vaccination programs is true?
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Administratively, billing for vaccines covered by Medicare Part D may be easier for pharmacists than physicians.
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Which of the following is the best example of a group that individual pharmacists can collaborate with to help increase immunization rates?
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Immunization coalitions.
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What is an example of mass screening?
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Providing vaccine information at a booth of a health fair.
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What is an example of a procedure-based screening?
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Recommending vaccinations for a patient undergoing a splenectomy.
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What is an example of an occurrence-based screening?
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Providing hospital discharge counseling to a patient.
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What type of immunity targets pathogens that are circulating freely in body fluids, such as blood, plasma, and lymph.
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Humoral immunity
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What is the written vaccine update source also known as the "pink book?"
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Epidemiology and Prevention of Vaccine-Preventable Diseases.
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What form is required to receive compensation for giving a vaccination?
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CMS-1500.